Individual
DENISE WOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
2151 FOUNTAIN DR, SUITE 101, SNELLVILLE, GA 30078-6783
(770) 979-9996
Mailing address
PO BOX 525, SNELLVILLE, GA 30078-0525
(770) 979-9996
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN139540
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197715386A
—
GA
Enumeration date
11/17/2005
Last updated
10/10/2013
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